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Journal ArticleDOI

Plasmodium falciparum and intestinal parasitic co-infections in HIV-infected patients in Benin City, Edo State, Nigeria

14 May 2012-Journal of Infection in Developing Countries (J Infect Dev Ctries)-Vol. 6, Iss: 5, pp 430-435

TL;DR: Evidence of co-infections between Plasmodium falciparum and intestinal parasites in HIV and intestinal parasitic infections is provided as this will enhance better management of HIV-infected patients.

AbstractIntroduction: Human co-infection with Plasmodium falciparum and helminthes is ubiquitous throughout Africa. This study aimed to determine the co-infections of Plasmodium falciparum infection in HIV and intestinal parasitic infections, and their immunological distribution, in Benin City, Nigeria. Methodology: A total of 2,000 stool specimens from HIV-positive patients and 500 controls (HIV-negative individuals) were examined for ova, cysts, or parasites using standard procedures. In addition, patients' blood samples were analyzed for CD4 counts by flow cytometry and examined for Plasmodium falciparum by microscopy. Results: The prevalence of single parasitic infection among HIV patients was 18.1% in males and 16.9% among females with no significant difference (p = 0.536) while gender was a risk factor in multiple parasitic infections (male versus female: 4.2% and 1.8% OR = 2.384; 95% CI = 1.371, 4.147) (p = 0.0025). Increasing age was not associated with increased risk of both single and multiple parasitic infections (p = 0.083; p = 0.248). CD4 + T cell count less than 200 cells/µl was a risk factor for acquiring single and multiple parasitic infections among HIV patients (OR = 5.565; 95% CI = 4.136, 7.486; p = 0.0001; OR = 4.283; 95% CI = 2.424, 7.566; p = 0.0001). The most common co-infection observed was between Plasmodium falciparum and Ascaris lumbricoides 43% (10) among HIV patients. Conclusion: This study provides evidence of co-infections between Plasmodium falciparum and intestinal parasites. Diagnosis of parasitic infections among HIV patients is advocated as this will enhance better management of HIV-infected patients.

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Citations
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Journal ArticleDOI
TL;DR: Cryptosporidium prevailed in HIV-positive patients with diarrhea, and interestingly, polyparasitic infections were demonstrated in chronic cases with a low CD4 count, therefore, regular antienteric parasitic prophylactic trials are recommended in for patients with lowCD4 cell count.
Abstract: Objective One of the major health problems in patients with human immunodeficiency virus (HIV) is superimposed infections due to reduced immunity. It has long been recognized that the interactions between HIV and other infective agents, including parasites, significantly influence the health status of people living with HIV/acquired immunodeficiency syndrome. This study attempted to detect enteric parasites in HIV-positive and HIV-negative patients with diarrhea. Materials and Methods Stool samples were collected and examined for enteric parasites by light microscopy, modified acid fast stain, and modified trichrome stain methods. Results Intestinal parasitic pathogens were detected in 77.14% of patients infected with HIV and they were found to be significantly associated with opportunistic infections. Major pathogenic populations identified are Cryptosporidium spp. (47.14%), Blastocystis hominis (44.28%), Entamoeba histolytica (37.14%), Hymenolepis nana (30%), Isospora belli (28.57%), Giardia lamblia (25.71%), Cyclospora species (24.29%), Ascaris lumbricoides (22.85%), and Trichuris trichiura (18.57%). Conclusion Cryptosporidium spp. prevailed in HIV-positive patients with diarrhea, and interestingly, polyparasitic infections were demonstrated in chronic cases with a low CD4 count. Therefore, regular antienteric parasitic prophylactic trials are recommended in for patients with low CD4 cell count.

13 citations


Journal ArticleDOI
TL;DR: Although haemoglobin levels increased overall for patients on zidovudine-containing regimens, for those in the 10th and 90th percentiles haem oxygen levels trended downward over time, these results have implications for decisions regarding when to initiate, switch from or avoid the use of zidvudine.
Abstract: We conducted a study to assess trends in haemoglobin recovery among HIV-infected patients initiated on zidovudine-based combination antiretroviral therapy (cART) stratified by baseline haemoglobin level. Haemoglobin data from non-pregnant adult patients initiating cART in rural north-central Nigeria between June 2009 and May 2011 were analysed using a linear mixed effects model to assess the interaction between time, zidovudine-containing regimen and baseline haemoglobin level on the outcome of subsequent haemoglobin level. Best-fit curves were created for baseline haemoglobin in the 10th, 25th, 75th and 90th percentiles. We included 313 patients with 736 measures of haemoglobin in the analysis (239 on zidovudine and 74 on non-zidovudine-containing regimens). Median haemoglobin increased over time in both groups, with differences in haemoglobin response over time related to baseline haemoglobin levels and zidovudine use (p = 0.003). The groups of patients on zidovudine at the 10th and 90th percentiles had downward sloping curves while all other groups had upward trending haemoglobin levels. Although haemoglobin levels increased overall for patients on zidovudine-containing regimens, for those in the 10th and 90th percentiles haemoglobin levels trended downward over time. These results have implications for decisions regarding when to initiate, switch from or avoid the use of zidovudine.

8 citations


Journal ArticleDOI
TL;DR: The results suggest that other factors are involved in this complex interaction between HIV and malaria, and that Plasmodium falciparum is the only species infecting patients on anti-malarial and anti-retroviral drugs.
Abstract: The Human immunodeficiency virus (HIV) and malaria are two of the world’s most formidable pathogens. Coinfection has been shown to amplify the effects of both diseases with HIV infection enhancing the severity of malaria. Previous work in our laboratory has shown that individuals infected with malaria and HIV who are taking anti-retrovirals have the Plasmodium parasite in their bloodstream suggesting that the lack of anti-malarials in their drug regimen resulted in Plasmodium infection. In this study, we set out to determine the status of Plasmodium infection in a cohort of patients taking both anti-malarial and anti-retroviral drugs. Blood samples were collected from patients of the Edo district of Nigeria in Benin City co-infected with Plasmodium and HIV. We have found that 31 out of the 317 (9.78%) HIV patients on HAART and ACT had Plasmodium in their blood based on microscopic counts. Surprisingly, using the polymerase chain reaction (PCR), the prevalence was at 25.6% for Plasmodium. In addition, we have identified by PCR that Plasmodium falciparum is the only species infecting these patients. Furthermore, no significant relationship was found to exist between CD4+ T-cell counts and malarial infections (CD4 count<200 cells/µL (7.20%)) nor was the malaria parasite density significantly associated with CD4 count<200 cells/µL (P=0.595) in this study population in Benin City, Nigeria. These results suggest that other factors are involved in this complex interaction.

8 citations


Cites background from "Plasmodium falciparum and intestina..."

  • ...In this study, we surveyed HIV and falciparum malaria co-infections, in Benin City, Nigeria, among patients prescribed with HAART (zidovudine, stavudine, and nevirapine) and ACT (artesunate-lumenfantrine combination) medications....

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  • ...The teaching hospital is a tertiary health institution with a referral status serving 5 States of the Nigerian Federation: Edo, Delta, Ondo, *Corresponding author: Johanna Porter-Kelley, Department of Life Sciences, Winston-Salem State University, 601 Martin Luther King Dr. Winston Salem, NC 27110, USA, Tel: 336-750-3239; E-mail: porterkelleyj@wssu.edu Received July 20, 2013; Accepted September 09, 2013; Published October 16, 2013 Citation: Akinbo FO, Omoregie R, Dixon L, Brown K, Wilson R, et al. (2013) CoEndemicity of Plasmodium falciparum and HIV-Infections in Treated Patients is Uncorrelated in Benin City, Nigeria....

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  • ...%)) nor was the malaria parasite density significantly associated with CD4 count<200 cells/µL (P=0.595) in this study population in Benin City, Nigeria....

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  • ...falciparum and Ascaris lumbricoides in HIV-infected patients in Benin City, Nigeria [22]....

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  • ...In previous surveys of HIV and malaria co-infections in Benin City, Nigeria, patients prescribed with HAART and ACT were excluded and a higher Plasmodium infection rate was observed in HIVinfected individuals [14]....

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Journal ArticleDOI
TL;DR: The source of water, type of toilet and presence of diarrhoea significantly affected the prevalence of intestinal parasitic infections among artisans, and A. lumbricoides was the most prevalent parasitic agent recovered in this study.
Abstract: Context: Human intestinal parasites have always been a major health problem in the developing countries. This study was aimed at determining the prevalence of intestinal parasitic infections among artisans and establishes a relationship between the prevalence of intestinal parasitic infections and risk-factors. Materials and Methods: A total of 353 participants which consisted of 272 males and 81 females were recruited for this study with age ranging from 18 to 65 years. Stool specimens were collected from the participants and analysed using the standard technique. The data obtained were analysed using Chi-square (χ2 ) to compare the frequency data while the odd ratio was calculated for potential risk factors. Results: Out of 353 subjects, 118 (33.4%) subjects had intestinal parasitic infections. Age, gender, marital status, occupation, educational status and source of food did not significantly affect (P = 0.219, P = 0.920, P = 0.276, P = 0.087, P = 0.074 and P = 0.442, respectively) the prevalence of intestinal parasitic infections. The use of well/rain water (odds ratio [OR] =2.721; 95% confidence interval [CI] = 1.452, 5.100; P = 0.002) and presence of diarrhoea (OR = 6.169; 95% CI = 3.665, 10.474; P < 0.0001) were significantly associated with intestinal parasitic infections among artisans. Defecating in nearby bushes resulted in a significantly increased prevalence of intestinal parasitic infections among artisans (P < 0.0001). The intestinal parasites recovered were Ascaris lumbricoides, hookworm, Trichuris trichiura and Entamoeba histolytica. A. lumbricoides had the highest prevalence (77.8%). The male gender had the highest prevalence in all the four intestinal parasites recovered in this study. Conclusion: Overall prevalence of 34.4% of intestinal parasitic infections was observed among artisans in Benin City. The source of water, type of toilet and presence of diarrhoea significantly affected the prevalence of intestinal parasitic infections among artisans. A. lumbricoides was the most prevalent parasitic agent recovered in this study.

6 citations


01 Jan 2015
TL;DR: The human immunodeficiency virus (HIV) infection has continued to pose a lot of challenges to global health and it is posited that the prevalence of these parasites has more to do with sanitary status and living conditions than immune status.
Abstract: The human immunodeficiency virus (HIV) infection has continued to pose a lot of challenges to global health. About 4.5 million infected people live in Nigeria (Tyodugh et al., 2012). The infection is known to have altered both epidemiology and outcome of opportunistic parasiticinfections hitherto known as one of the most significant causes of illness in developing countries (Tian et al., 2012). Parasitic infections reported as the hallmark of AIDS (Ramakrishnan et al., 2007) have also been reported to have no significant difference in prevalence between HIV positive and HIV negative individuals (Berenji et al., 2012; Yosefi et al., 2012). In fact, Poka and associates posited that the prevalence of these parasites has more to do with sanitary status and living conditions than immune status (Poka et al., 2012). ISSN: 2319-7706 Volume 4 Number 4 (2015) pp. 768-776 http://www.ijcmas.com

1 citations


Cites result from "Plasmodium falciparum and intestina..."

  • ...This agrees with findings by Akinbo and coworkers in Benin city (Akinbo et al., 2012) but is in contrast to reports by Ekejindu et al. (2011) in Nigeria, Asmaet al. (2011) in Malaysia and Ramakrishnan (2007) in India....

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  • ...This agrees with findings by Akinbo and coworkers in Benin city (Akinbo et al., 2012) but is in contrast to reports by Ekejindu et al....

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References
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Book
01 Jan 1976
TL;DR: One that the authors will refer to break the boredom in reading is choosing introduction to medical laboratory technology as the reading material.
Abstract: Introducing a new hobby for other people may inspire them to join with you. Reading, as one of mutual hobby, is considered as the very easy hobby to do. But, many people are not interested in this hobby. Why? Boring is the reason of why. However, this feel actually can deal with the book and time of you reading. Yeah, one that we will refer to break the boredom in reading is choosing introduction to medical laboratory technology as the reading material.

359 citations


Journal ArticleDOI
TL;DR: Re-analysis of existing data suggests that co-infection with P. falciparum and hookworm has an additive impact on hemoglobin, exacerbating anemia-related malarial disease burden and it is suggested that both school-age children and pregnant women would benefit from an integrated approach to malaria and helminth control.
Abstract: Human co-infection with Plasmodium falciparum and helminths is ubiquitous throughout Africa, although its public health significance remains a topic for which there are many unknowns. In this review, we adopted an empirical approach to studying the geography and epidemiology of co-infection and associations between patterns of co-infection and hemoglobin in different age groups. Analysis highlights the extensive geographic overlap between P. falciparum and the major human helminth infections in Africa, with the population at coincident risk of infection greatest for hook- worm. Age infection profiles indicate that school-age children are at the highest risk of co-infection, and re-analysis of existing data suggests that co-infection with P. falciparum and hookworm has an additive impact on hemoglobin, exacerbating anemia-related malarial disease burden. We suggest that both school-age children and pregnant women— groups which have the highest risk of anemia—would benefit from an integrated approach to malaria and helminth control.

298 citations


"Plasmodium falciparum and intestina..." refers background in this paper

  • ...Human coinfection with Plasmodium falciparum and helminthes is ubiquitous throughout Africa, although much remains unknown about its impact on public health [4]....

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Journal ArticleDOI
TL;DR: Results suggest that, compared with those infected, individuals free of helminths had the same degree of protection against malaria as that provided by sickle-cell trait, the most potent factor of resistance to malaria identified to date.
Abstract: The influence of intestinal worm infections on malaria was studied in individuals from Dielmo, Senegal in 1998. Results suggest that, compared with those infected, individuals free of helminths had the same degree of protection against malaria as that provided by sickle-cell trait, the most potent factor of resistance to malaria identified to date.

186 citations


"Plasmodium falciparum and intestina..." refers result in this paper

  • ...Similar findings have been reported among a population of unknown HIV status [19,20]....

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Journal ArticleDOI
TL;DR: An overview of the available data on the interactions between HIV and tropical pathogens is presented, and Tropical protozoa are discussed here; other tropical pathogens are discussed in a related mini-review in this issue of Clinical Infectious Diseases.
Abstract: The brunt of the human immunodeficiency virus (HIV) pandemic has been borne disproportionately by resource-poor regions of the world, where tropical infectious diseases continue to hold greatest sway. As a result, our understanding of the epidemiological, biological, and clinical interactions between HIV and tropical pathogens has lagged, compared with our understanding of the interactions between HIV and pathogens that are common in the industrialized world. Because of the current rapid expansion of HIV care in the tropics, with increasing resources being made available, an overview of the available data is timely. Tropical protozoa are discussed here; other tropical pathogens are discussed in a related mini-review in this issue of Clinical Infectious Diseases.

87 citations


"Plasmodium falciparum and intestina..." refers background in this paper

  • ...Discussion The brunt of the human immunodeficiency virus (HIV) pandemic has been borne disproportionately by resource-poor regions of the world, where tropical infectious diseases continue to hold greatest sway [10]....

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Journal ArticleDOI
TL;DR: Hookworm-P.
Abstract: Introduction Helminth infections and malaria are widespread in the tropics. Recent studies suggest helminth infections may increase susceptibility to malaria. If confirmed, this could be particularly important during pregnancy-induced immunosuppression.

77 citations